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A Conversation With Robert Gish, MD

In this issue, HCV Next asks five questions of Robert Gish, MD, who holds a number of positions, including clinical professor of Medicine (Adjunct) at the University of Nevada in Las Vegas, clinical professor of Medicine at Stanford University (Consultant) and clinical professor of Medicine, Senior Medical Director at St Joseph’s Hospital and Medical Center in Phoenix, Medical Director La Maestra, as well as leadership in National Viral Hepatitis Roundtable, Hepatitis B Foundation and Vietnam Viral Hepatitis Alliance, in addition to running his own consulting firm.

Gish began his life in medicine at the Pharmacy School at the University of Kansas in 1974. He completed his MD at the University of Kansas Medical School in 1980. It was then on to the University of California, San Diego for a residency in internal medicine and a fellowship in gastroenterology and hepatology at the University of California, Los Angeles. From there, he moved north to San Francisco to work in various capacities leading the liver transplantation at the California Pacific Medical Center with a current position at Stanford University.

Society memberships for Dr. Gish include the American Association for the Study of Liver Disease, European Association for the Study of Liver Disease, Asian Pacific Association for the Study of the Liver and the American Society of Transplant Physicians. He is also on the editorial boards of American Journal of Gastroenterology, Journal of Hepatology, Digestive Diseases and Sciences, Gastroenterology, Hepatology, Liver Transplantation and Surgery, and Journal of Viral Hepatitis. The NIH presented him with the Physician Scientist Award for research into calcium signaling in liver cells.

Who has had the greatest influence on your career?

Neil Kaplowitz, MD, Holder of USC Associates/Thomas H. Brem Chair in Medicine and Budnick Chair in Liver Disease at the University of Southern California, greatly influenced my career. He has skills both in basic science research as well as in the clinic and at the patient bedside.

What area of research in hepatology most interests you right now and why?

Hepatitis B, because it is not yet curable. There are many new advances taking place with direct- and indirect-acting antiviral agents, and we are applying new technologies such as interferon RNA and anti-sense, as well as new immune modulators.

What advice would you offer a student in medical school today?

I would encourage students to focus on research, humanistic approaches to medicine and the business of medicine.

Have you ever been fortunate enough to witness or to been part of medical history in the making? If so, please explain.

Recent iRNA research from Arrowhead Pharma has shown that the production of hepatitis B surface from integrated virus can occur at the same time as HBsAg from cccDNA. This information has changed our perception on the importance HBV integration into the human genome and the production of viral building blocks in the hepatocyte and release into the serum. This data provides information for a paradigm shift in terms of assessing end-points for clinical studies and determination of viral clearance and potential clearance of cccDNA.

What’s up next for you?

HCV and HBV eradication. Specifically, I will be working with the U.S. CDC and the WHO, in the United States, Vietnam, the Philippines and Armenia/Georgia.

Disclosure: Gish reports receiving options for Arrowhead and consulting relationships as posted on robertgish.com.